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General NPI Number Information
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NPI Number | 1053263319
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Entity Type | Individual
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Provider Name | DEVIN TAYLOR RIVET ATP - SOCM
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Gender | Male
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 843 NORMANDY DR, FORT BRAGG, NC, 28310
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City | APO
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State | AA
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Zip | 28310
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Country | US
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Telephone | 910-432-8193
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Fax | 910-907-2778
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Provider Business Mailing Address
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Address Line | 843 NORMANDY DR, FORT BRAGG, NC, 28310
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City | APO
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State | AA
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Zip | 28310
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Country | US
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Telephone | 910-432-8193
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Fax | 910-907-2778
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number | 06205177DR
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License Number State | NC
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